Pederzol, Bert
Pederzol, Bert is an sole proprietor health care provider with primary practice located at 1650 S Union Ave , Alliance OH 44601-4349. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Pederzol, Bert can be contacted via phone (330) 630-9699.Contact Information
Primary practice address
1650 S Union Ave
Alliance OH 44601-4349
Phone: (330) 630-9699
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3261 | Ohio |
Profile Details
| NPI number | 1649338112 |
|---|---|
| LBN Legal business name | Pederzol, Bert |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 5th, 2006 |
| Last updated | Jun 8th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649338112 | NPPES |
| Ohio | MEDICAID | 0311219 | |
| Ohio | Other | 000000131061 |
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